Patient portals and PHRs: What’s the difference?
They both let patients access health information from a browser or device.
They both help engage patients and improve health.
But do you really know what separates a patient portal from a personal health record (PHR)? And which one fits your need?
We asked Sue Dyson and Antoine Dagher, senior product managers at TELUS Health, to tell us what sets these two patient engagement solutions apart.
SD: From my perspective, the main difference between a patient portal and a PHR lies in data custodianship.
So who manages the data?
SD: Physicians are the data custodians in a patient portal. Portals give patients access to select information from their chart in that specific clinic’s electronic medical record (EMR). Typically, patients can’t upload their own health information.
AD: With consumer-owned personal health records (PHRs), patients are the custodians. They can upload their own health data (from wearables, health trackers, devices like glucometres, for example) and put it together with their provincial or regional health data for a much broader picture. If anyone else wants to see their data, patients must grant permission.
Who provides the system?
SD: Clinics or other healthcare organizations with EMRs offer portals to their patients, effectively giving patients a view into their chart in the EMR, and a platform to connect with the clinic.
AD: PHRs are usually offered by health organizations, associations or agencies. Several provinces in Western Canada, for example, provide residents with a PHR for their own use. These Provincial PHRs double as a health promotion tool. A diabetes or mental health program may offer a PHR to improve health outcomes through engagement. Hospitals and clinics may also make a PHR available. No matter who provides it, patients always own the data and control access.
What do people use them for?
SD: Patients can use portals to see their health records. Depending on the portal, patients may be able to view appointment notes, lab results, immunization history, allergies, medication info and other health information.
But more commonly, patients use portals for the convenience of online booking, the comfort of secure messaging with their health team, and the peace of mind of receiving reminders for appointments or medications. Clinics can tailor their portal to run more efficiently: setting up recalls keeps patients up to date on preventative care measures, for example. Solutions like our new Health Myself web-based portal for Med Access and PS Suite give patients a convenient way to connect with their clinic. When we can improve access for patients and increase productivity at the clinic, that’s a win for everyone.
AD: PHRs may also offer these services. But people most commonly use them to view their inputted health metrics together with provincial or hospital data such as medications, test results, immunizations and clinical encounters.
Some PHRs are designed for patients to better manage chronic conditions or get support for mental illness through collaboration with their caregivers. They can complete health assessments and journals, interact with their health team, upload data from devices, watch for issues, and track progress against care plans. Authorized clinicians can monitor data in the PHR, receive alerts and adjust care plans if needed.
PHRs offered through hospitals or governments are usually more general in scope. Patients can view their health information, access wellness and public health recommendations, and track progress on health and fitness goals. The focus with these PHRs is typically more on education and prevention.
Why do portals and PHRs exist side by side but don’t work together?
SD: In an ideal world, patients would be engaged through a highly functional platform that integrates portals and PHRs. But in many instances across Canada, they’re still separate products.
Why? The best analogy I can think of is from the financial world. A portal is like online banking, which gives me a window into my financial information with that particular bank. The bank controls that data. I can view it, pay bills, order products, and export information, but I can’t change my balance to $1 million, even though I’d like to!
A PHR, on the other hand, is like a personal finance management tool. I can upload financial information from multiple sources to Quicken, for example, including banking info from the various banks I work with. Only I have access to this consolidated view, unless I grant access to someone, like my accountant or my spouse.
Because not everyone wants or needs to use Quicken, right now there’s a place for both as complementary tools.
Is there overlap?
AD: With so many patient engagement tools available today, there is, of course, variety – and overlap. While each has its own niche right now, in some areas of Canada, we will start to see these solutions work together in a more integrated way.
We also expect to see these kinds of patient engagement tools evolve as we strive to improve health outcomes and reduce system costs by empowering patients with more ownership of their health. Patients and providers alike are finding new ways to make health information more relevant and complete. We expect many developments in this area in the coming months and years.